Cystic and cavitary lung diseases: Focal and diffuse

Jay H Ryu, Stephen J. Swensen

Research output: Contribution to journalArticle

120 Citations (Scopus)

Abstract

Cysts and cavities are commonly encountered abnormalities on chest radiography and chest computed tomography. Occasionally, the underlying nature of the lesions can be readily apparent as in bullae associated with emphysema. Other times, cystic and cavitary lung lesions can be a diagnostic challenge. In such circumstances, distinguishing cysts (wall thickness ≤4 mm) from cavities (wall thickness >4 mm or a surrounding infiltrate or mass) and focal or multifocal disease from diffuse involvement facilitates the diagnostic process. Other radiological characteristics, including size, inner wall contour, nature of contents, and location, when correlated with the clinical context and tempo of the disease process provide the most helpful diagnostic clues. Focal or multifocal cystic lesions include blebs, bullae, pneumatoceles, congenital cystic lesions, traumatic lesions, and several infectious processes, including coccidioidomycosis, Pneumocystis carinii pneumonia, and hydatid disease. Malignant lesions including metastatic lesions may rarely present as cystic lesions. Focal or multifocal cavitary lesions include neoplasms such as bronchogenic carcinomas and lymphomas, many types of infections or abscesses, immunologic disorders such as Wegener granulomatosis and rheumatoid nodule, pulmonary infarct, septic embolism, progressive massive fibrosis with pneumoconiosis, lymphocytic interstitial pneumonia, localized bronchiectasis, and some congenital lesions. Diffuse involvement with cystic or cavitary lesions may be seen in pulmonary lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis, honeycomb lung associated with advanced fibrosis, diffuse bronchiectasis, and, rarely, metastatic disease. High-resolution computed tomography of the chest frequently helps define morphologic features that may serve as important clues regarding the nature of cystic and cavitary lesions in the lung.

Original languageEnglish (US)
Pages (from-to)744-752
Number of pages9
JournalMayo Clinic Proceedings
Volume78
Issue number6
StatePublished - Jun 1 2003

Fingerprint

Lung
Blister
Bronchiectasis
Thorax
Cysts
Fibrosis
Rheumatoid Nodule
Tomography
Lymphangioleiomyomatosis
Coccidioidomycosis
Pneumoconiosis
Langerhans Cell Histiocytosis
Granulomatosis with Polyangiitis
Pneumocystis Pneumonia
Bronchogenic Carcinoma
Interstitial Lung Diseases
Emphysema
Embolism
Radiography
Abscess

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cystic and cavitary lung diseases : Focal and diffuse. / Ryu, Jay H; Swensen, Stephen J.

In: Mayo Clinic Proceedings, Vol. 78, No. 6, 01.06.2003, p. 744-752.

Research output: Contribution to journalArticle

Ryu, JH & Swensen, SJ 2003, 'Cystic and cavitary lung diseases: Focal and diffuse', Mayo Clinic Proceedings, vol. 78, no. 6, pp. 744-752.
Ryu, Jay H ; Swensen, Stephen J. / Cystic and cavitary lung diseases : Focal and diffuse. In: Mayo Clinic Proceedings. 2003 ; Vol. 78, No. 6. pp. 744-752.
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